Introduction

Depression is very common - one in five people become depressed at some point in their lives. Anyone can get low, but someone is said to be suffering from depression when these feelings don’t go away quickly or become so bad they interfere with their everyday life.

Depression can last for a few months. You can get better, only for the depression return again. It is usual to recover from depression, but it is also common for the depression to return. Episodes can last several months (or even longer in some instances).

Why do people get depressed?

Sometimes there may be an obvious reason for becoming depressed, sometimes not. The reason may seem obvious – a relationship breakdown or a bereavement or even the birth of a child – sometimes it is not clear. Either way, these feelings can become so bad that you need help.

What does it feel like to be depressed?

The feeling of depression is deeper, longer and more unpleasant than the short episodes of unhappiness that everyone experiences occasionally.

You will notice:

  • persistent sadness or low mood
  • not being able to enjoy things
  • losing interest in life
  • finding it harder to make decisions
  • not coping with things that used to be easy
  • feeling exhausted
  • feeling restless and agitated;
  • loss of appetite and weight
  • difficulties getting to sleep
  • loss of sex drive
  • thoughts of self-harm or suicide.

Doctors grade depression as mild, moderate and severe to help them decide which treatment to choose.

How do I know if I am depressed?

You may not realise how depressed you are because it has come on so gradually. You may try to struggle on and cope by keeping busy. This can make you even more stressed and exhausted. Physical pains, such as constant headaches or sleeplessness, then start. Sometimes these physical symptoms can be the first sign of a depression.

What help and treatment is available?
  • Self-help: there are now a number of self-help books and computer programmes based on Cognitive Behavioural Therapy (CBT) for depression.
  • Talking treatments: there are several different types of talking treatments. Counselling enables you to talk about your feelings to a professional. Your GP may have a counsellor at the surgery who you can talk to.
  • Cognitive Behavioural Therapy helps people overcome the negative thoughts that can sometimes be the cause of depression.
  • If you have become depressed while suffering from a disability or caring for a relative, then a self-help group may give you the support you need.
  • Medication: Antidepressants can help if your depression is severe or goes on for a long time. They can help you to feel less anxious and cope better so that you can start to enjoy life and deal with problems effectively again. It is important to remember that you won't feel the effect of antidepressants straight away. People often don't notice any improvement in their mood for 2 or 3 weeks.
  • As well as tablets, there is an alternative remedy called St John's Wort available from chemists. This can help in mild to moderate depression. It seems to work in much the same way as an antidepressant, but some people find that it has fewer side-effects. If you are taking other medication, it's important to tell your doctor before taking St John’s Wort.
Which is right for me – self-help. talking treatments or tablets?

It depends on how your depression has developed and how severe it is. On the whole, self-help and talking treatments are best for mild depression. They are equally helpful for moderate depression. If you depression is severe, you are more likely to need antidepressants.

What will happen if I don’t get treatment?

Many depressions will go away eventually, but it may take many months. A small number of people with depression will take their own lives.

What can I do to help myself?
  • Tell someone how you feel.
  • Try to keep active. Even just going for a walk regularly can help your mood and sleep pattern. Doing things can help to take you mind off thoughts that make you depressed.
  • Make sure you eat well.
  • Be careful with alcohol as it makes depression worse.
  • Try not to get worried if you can’t sleep, but do something relaxing in bed such as reading, watching TV or listening to the radio.
  • If you think you know what is causing your depression, it can help to write down the problem and then think of the things you could do to tackle it. Pick the best actions and see if they work.

  • Also try to keep hopeful. This is a very common experience and you will come through it, probably stronger and more able to cope than before.

How can I help someone who is depressed?
  • Listen to them, but try not to judge them.
  • Don’t offer advice unless they ask for it, but if you can see the problem that is behind the depression, you could work with the person to find a solution.
  • Spending time with them, listening over and over to their problems, and encouraging them to keep going with activities in their routine, is all helpful.

If they are getting worse, encourage them to visit their doctor and to accept treatment.

For more in-depth information see our main leaflet: Depression.

This leaflet reflects the most up-to-date evidence at the time of writing.

Produced by the RCPsych Public Education Editorial Board.

Series Editor: Dr Philip Timms

Reviewed by Elaine Ellis

© March 2014. Due for review: March 2016.